Klemme W R, Polly D W, Orchowski J R
Department of Orthopaedic Surgery and Rehabilitation, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA.
J Pediatr Orthop. 2001 Nov-Dec;21(6):761-4.
The present study reports the results of a consecutive series of six very young children who underwent single-anesthetic sequential anterior and posterior hemivertebral excision. The children, all less than 34 months old (mean age 19 months), presented with high magnitude or progressive congenital scoliosis related to an unbalanced hemivertebra. Curve correction required hemivertebral excision, which was accomplished during a single operative event using sequential anterior and posterior procedures. The intraoperative curve correction was maintained with plaster immobilization for 3 months. All patients were followed for at least 24 months. Pre-and postoperative spinal radiographs were analyzed for initial and final curve correction. Excellent correction of preoperative deformity was obtained and maintained throughout the follow-up period. The mean postoperative curve correction (67%; range 52%-84%) compared favorably with the average correction at final follow-up (70%; range 50%-85%). Radiographs revealed a consistently solid arthrodesis with no evidence of curve progression. There were no neurologic or other significant complications. In conclusion, single-anesthetic sequential anterior and posterior hemivertebral excision appears to be a safe and efficacious procedure for the management of congenital scoliosis in very young children.
本研究报告了连续6例非常年幼的儿童接受单次麻醉下前后半椎体序贯切除的结果。这些儿童均小于34个月（平均年龄19个月），因半椎体失衡出现严重或进展性先天性脊柱侧凸。矫正侧弯需要切除半椎体，这在单次手术中通过前后序贯手术完成。术中通过石膏固定维持侧弯矫正3个月。所有患者至少随访24个月。分析术前和术后脊柱X线片以评估初始和最终的侧弯矫正情况。术前畸形得到了良好矫正，并在整个随访期内保持。术后平均侧弯矫正率为67%（范围52%-84%），与末次随访时的平均矫正率（70%；范围50%-85%）相比良好。X线片显示融合始终稳固，无侧弯进展迹象。无神经或其他严重并发症。总之，单次麻醉下前后半椎体序贯切除似乎是治疗非常年幼儿童先天性脊柱侧凸的一种安全有效的方法。
